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Licensed Unlicensed Requires Authentication Published by De Gruyter July 27, 2018

Intracranial pathologies associated with central diabetes insipidus in infants

  • Nader Kasim ORCID logo EMAIL logo , Bindiya Bagga and Alicia Diaz-Thomas

Abstract

Background

Idiopathic central diabetes insipidus (CDI) has been associated with intracranial pathologies that do not involve the structural pituitary gland or hypothalamus. The objective was to study the association between non-structural hypothalamic/pituitary intracranial pathologies (NSHPIP) with CDI and to review etiologies that may be contributory to the development of CDI.

Methods

A retrospective query of our intra-institutional database from 2006 to 2015. Children admitted diagnosed with diabetes insipidus (DI) (ICD-9 253.5) between the ages of 0–1 year were included. Patient charts were reviewed to include those who have a documented diagnosis of CDI, hypernatremia (>145 mmol/L), high serum osmolality (>300 mOsm/kg), low urine osmolality (<300 mOsm/kg), and brain imaging reports. Diagnoses of nephrogenic DI were excluded.

Results

Twenty-three infant patients were diagnosed with CDI. Eleven subjects (48%) had NSHPIP. Of those, 18% had cerebral infarction, 27% had intracranial injury and hemorrhage due to traumatic brain injury, 18% had isolated intraventricular hemorrhage, and 27% had meningitis. Hospital prevalence for NSHPIP, age 0–1 year, ranged from 0.05% to 0.3%.

Conclusions

Rates of NSHPIP in those with CDI are higher than expected hospital rates (p<0.001), suggesting a possible association between CDI and NSHPIP.


Corresponding author: Nader Kasim, MD, Department of Pediatric Endocrinology, Le Bonheur Children’s Hospital, 49 North Dunlap Street, Room 119, Memphis, TN 38105, USA; and University of Tennessee Health Science Center, Memphis, TN, USA, Phone: +901-287-6481

Acknowledgments

Thank you to Dr. Fatih Sen, PhD from the Children’s Foundation Research Institute at Le Bonheur Children’s Hospital for his assistance in data extraction. Thank you to Dr. Pallavi Iyer, MD from Children’s of Alabama for proof reading the manuscript.

  1. Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.

  2. Research funding: None declared.

  3. Employment or leadership: None declared.

  4. Honorarium: None declared.

  5. Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.

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Received: 2017-08-03
Accepted: 2018-06-18
Published Online: 2018-07-27
Published in Print: 2018-09-25

©2018 Walter de Gruyter GmbH, Berlin/Boston

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